DEVELOPING OPTIMAL SEARCH STRATEGIES FOR DETECTING CLINICALLY SOUND STUDIES IN MEDLINE
DEVELOPING OPTIMAL SEARCH STRATEGIES FOR DETECTING CLINICALLY SOUND STUDIES IN MEDLINE
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DOI：
10.1136/jamia.1994.95153434
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发表时间：
1994-11-01
影响因子：
6.4
通讯作者：
SINCLAIR, JC
中科院分区：
文献类型：
--
作者：
HAYNES, RB;WILCZYNSKI, N;SINCLAIR, JC
目的：开发最佳的 MEDLINE 搜索策略，用于检索成人普通医学疾病的病因学、预后、诊断、预防或治疗的健全临床研究。设计：对搜索策略的操作特征进行分析调查，这些搜索策略由计算机化的术语组合开发，用于检测符合成人普通医学直接临床使用的基本方法学标准的研究。测量：通过与所有搜索术语的手动审查进行比较，确定 134,264 个独特搜索术语组合的敏感性、特异性、精确度和准确度。 1986 年和 1991 年十种内科和普通医学期刊上发表的文章（“黄金标准”）。结果：不到一半的感兴趣主题的研究符合测试临床应用的科学价值的基本标准。 1991 年，搜索词组合在病因学研究方面达到了 82% 的峰值灵敏度，在预后方面达到了 92%，在诊断方面达到了 92%，在治疗方面达到了 99%。与最佳的单个术语相比，多个术语将声音研究的灵敏度提高了 30% 以上（绝对增加），但当灵敏度最大化时，特异性会有所损失。 1986 年，联合治疗对于病因的敏感性达到峰值 72%，对于预后的敏感性达到 95%，对于诊断的敏感性达到 86%，对于治疗的敏感性达到 98%。当组合搜索词以最大化特异性时，这两年所有目的类别的特异性都达到了 93% 以上。与单个术语相比，组合术语实现了近乎完美的特异性，并且在除治疗之外的所有目的类别中的敏感性均略有增加。通过组合所有目的类别的术语，实现了准确性的提高，1986 年和 1991 年治疗的峰值准确性达到 90% 以上。结论：通过选择索引术语和文本单词的组合，可以大大增强 MEDLINE 中引用的重要临床主题研究的检索。
Objective: To develop optimal MEDLINE search strategies for retrieving sound clinical studies of the etiology, prognosis, diagnosis, prevention, or treatment of disorders in adult general medicine.Design: Analytic survey of operating characteristics of search strategies developed by computerized combinations of terms selected to detect studies meeting basic methodologic criteria for direct clinical use in adult general medicine.Measures: The sensitivities, specificities, precision, and accuracy of 134,264 unique combinations of search terms were determined by comparison with a manual review of all articles (the ''gold standard'') in ten internal medicine and general medicine journals for 1986 and 1991.Results: Less than half of the studies of the topics of interest met basic criteria for scientific merit for testing clinical applications. Combinations of search terms reached peak sensitivities of 82% for sound studies of etiology, 92% for prognosis, 92% for diagnosis, and 99% for therapy in 1991. Compared with the best single terms, multiple terms increased sensitivity for sound studies by over 30% (absolute increase), but with some loss of specificity when sensitivity was maximized. For 1986, combinations reached peak sensitivities of 72% for etiology, 95% for prognosis, 86% for diagnosis, and 98% for therapy. When search terms were combined to maximize specificity, over 93% specificity was achieved for all purpose categories in both years. Compared with individual terms, combined terms achieved near-perfect specificity that was maintained with modest increases in sensitivity in all purpose categories except therapy. Increases in accuracy were achieved by combining terms for all purpose categories, with peak accuracies reaching over 90% for therapy in 1986 and 1991.Conclusions: The retrieval of studies of important clinical topics cited in MEDLINE can be substantially enhanced by selected combinations of indexing terms and textwords.